Development and Validation of a Low-Cost Drilling Model.

Background: Simulation models enable learners to have repeated practise at their own time, to master the psycho-motor and sensory acuity aspects of surgery and build their confidence in the procedure. The study aims to develop and evaluate the feasibility of a low-cost drilling model to train surgeons in the drilling task. The model targets three aspects of drilling - (1) Reduce plunge depth, (2) Ability to differentiate between bone and medullary canal and (3) Increase accuracy drilling in various angles. Methods: This cross-sectional study was conducted after obtaining ethics approval. We invited Consultants in the field of Orthopaedic or Hand Surgery to form the 'expert' group, and the 'novice' group consisted of participants who had no prior experience in bone drilling. We developed a drilling simulator model made from a polyvinyl chloride (PVC) pipe filled with liquid silicone. This model cost less than US$5. An electric Bosch drill (model GBM 10 RE) with a 1.4 mm K-wire 10 cm in length (6.5 cm outside the drill) was used for drilling. The main outcomes of the study were time taken for drilling, plunge depth, ability to penetrate the far cortex and accuracy. Results: Thirty-one participants were recruited into the study, of which 15 were experts and 16 were novices. The experts performed significantly better for plunge depth (t = -3.65, p = 0.0003) and accuracy (t = -2.07, p = 0.04). The experts required 20% less time to complete the drilling tasks, but it was not statistically significant (t = -0.79, p = 0.43). Conclusions: The low-cost drilling model could be useful in training Residents in the drilling task. It will allow Residents to practise independently at their own time and assess their own performance.

The epidemiology and distribution of hand fractures in Singapore.

Introduction: The aim of this study was to elucidate the epidemiology and distribution of hand fractures in Singapore. Methods: A total of 701 hand fractures in 596 patients aged 21 years and above from a single centre were reviewed from 2010 to 2011. Details regarding the patient demographics, occupation, mechanism of injury, associated injuries and treatment were obtained. Results: Hand fractures were particularly significant in patients between the ages of 21 and 40 years 58.9% of the total cases. The relative risk of hand fractures in males was 5.5 times greater than that in females. The majority of hand fractures occurred at the workplace (47.7%), with crush injury being the main mechanism of injury (33.6%). The most common locations of hand fracture were the little finger ray (31.2%) and distal phalanges (37.7%). There were 170 cases that underwent surgical fixation, which accounted for 24.3% of all fractures. Fixation rate was similar for both closed and open fractures but was significantly higher in the proximal and middle phalanges compared to the distal phalanx and metacarpal (P < 0.001). With regards to surgical fixation methods, wires were commonly used in either tuft fractures (100.0%) or intra-articular fractures (69.9%), whereas plates and screws were commonly used in shaft fractures (65.5%). Conclusion: The most significant population that sustained hand fractures in Singapore are young to middle-aged males who are skilled manual workers. The most commonly involved ray and location of hand fractures are the little finger ray and the distal phalanges, respectively, as they are in a relatively more exposed location.

Ambient air monitoring around the dioxin remediation site in Da Nang, Vietnam, using passive air samplers.

The concentrations and temporal variations of polychlorodibenzo-p-dioxins and polychlorodibenzofurans (PCDDs/PCDFs) in ambient air between March 2013 and February 2017 were investigated by passive air samplers containing polyurethane foam (PUF) disks in the dioxin remediation area using in-pile thermal desorption (IPTD) technology at Da Nang airport, Vietnam. The PCDD/PCDF concentrations in ambient air at each site depended on the location of the emission sources and the wind direction, the dioxin contamination level of excavated materials, the periods of excavation and transport, and the operation of the IPTD treatment system. The PCDD/PCDF concentrations were the highest in the former Agent Orange mixing and loading area (AOMLA), which was the closest to the IPTD system, with total toxic equivalent (TEQ) values ranging from 0.437 to 15.3 pg/PUF/day. The total TEQ concentrations in the Sen Lake area ranged from 0.138 to 2.41 pg/PUF/day. The lowest concentration of PCDDs/PCDFs occurred in the northern perimeter area, with total TEQ values ranging from 0.164 to 0.972 pg/PUF/day. The decreasing trend of the PCDD/PCDF concentrations in ambient air was confirmed over time at all three monitoring sites, among which there was a strong decrease in the former AOMLA after February 2015. Residents living near the Da Nang airport were at a low risk of being exposed to PCDDs/PCDFs through inhalation during remediation project implementation, while residents living close to the former AOMLA faced elevated risks with an average daily dose of PCDDs/PCDFs through inhalation ranging from 0.017 to 0.82 pg TEQ/kg body weight/day.

Nutritional conditions and oxygen concentration affect spontaneous occurrence of homologous recombination events but not spontaneous mutagenesis in Escherichia coli.

Effects of environmental factors for growth of Escherichia coli on spontaneous mutagenesis and homologous recombination events are described. By analyzing rifampicin-resistant (Rifr) mutation frequencies in an E. coli strain lacking MutM and MutY repair enzymes, which suppress base substitution mutations caused by 8-oxoguanine (7,8 dihydro-8-oxoguanine; 8-oxoG) in DNA, we examined levels of oxidative DNA damage produced in normally growing cells. The level of 8-oxoG DNA damage was about 9- and 63-fold higher in cells grown in M9-glucose and M9-glycerol media, respectively, than in those grown in LB medium. We also found that about 14-fold more 8-oxoG DNA damage was produced in cells grown in about 0.1% oxygen than in those grown in the normal atmosphere. However, Rifr mutation frequency in wild-type cells was unchanged in such different growth conditions, suggesting that the capacity of repair mechanisms is sufficient to suppress mutations caused by 8-oxoG even at very high levels in cells growing in the particular conditions. On the other hand, the frequency of spontaneous homologous recombination events in wild-type E. coli cells varied with different growth conditions. When cells were grown in M9-glucose and M9-glycerol media, the spontaneous recombination frequency increased to about 4.3- and 7.3-fold, respectively, higher than that in LB medium. Likewise, the spontaneous recombination frequency was about 3.5-fold higher in cells growing in the hypoxic condition than in cells growing in the atmosphere. When cells were grown in anaerobic conditions, the recombination frequency decreased to half of that in the atmosphere. These data indicated that spontaneous homologous recombination is highly responsive to environmental factors such as nutrition and oxygen concentration.